Health Affairs Panel on IOM GME report

Brad Poss, MD, MMM

Professor, Department of Pediatrics

Associate Dean for Graduate Medical Education

University of Utah School of Medicine

Medical Director, PICU

Primary Children’s Hospital

IOM GME Report (204 pages)

• Current GME funding:– Not meeting physician workforce needs– Non-transparent and outdated– Does not reward innovation– Lacks defined outcomes or metrics

IOM GME Recommendations

• Freeze GME funding at current levels– Adjusted for inflation

• Create two governmental organizations– CMS: Oversight of GME funding– HHS: Policy and Planning

• One Medicare GME fund– Operational Fund– Transformation Fund

GME Public Funding

Panel 1: GME Governance and Accountablity

• Gail Wilensky, Project Hope– Co-chair of IOM report

• Tom Nasca, ACGME– NAS, Milestones, CLER overview

• Steve Lipstein, BJC Healthcare– History of past reviews set up of next panel

Panel 2-The GME Pipeline: Is it Meeting Society’s Needs

• David Sklar, Academic Medicine• Stephen Shannon, AACOM• Edward Salsburg, GWU• Debra Weinstein, Partners Healthcare

System

Panel 3-Medicare Policy and the Future of GME

• Atul Grover, AAMC• Christopher Dawe, Dawe Health

Strategies• Glen Hackbarth, Medicare Payment

Advisory Commitee• Bruce Vladeck, Nexeria

AAMC Response to IOM Report

• Significant negative effects to proposed teaching hospitals cuts– Worsen physicians shortage as hospitals will

need to balance clinical and training demands– Reduce access to care (burn units,

transplants, PICUs, trauma, etc) and clinical trials

Local Opportunities

• Only academic medical center in a large geographic region-natural experiment– Potential for geographic redistribution

• Strengthen partnerships (VA, Intermountain, others)

• Increased collaboration across programs, SOM, HSC, and University

• VDO model for GME– Pediatrics, Surgery, Radiology